儿童艾滋病275例临床特点分析

Clinical characteristics of 275 pediatric cases of acquired immune deficiency syndrome

目的研究15岁以下AIDS患者的临床特点，了解HIV对患儿的影响。方法分析275例即将人选接受高效抗反转录病毒治疗患者的临床资料，对人口学、流行病学、临床分期、实验室特点及生长发育状况进行分析。结果275例AIDS患者主要以母婴途径传播为主，占78．9％，输血及血制品传播的为16．0％。平均年龄（7．6±3．7）岁，其中1岁以内5例，1～5岁104例，6岁以上166例。世界卫生组织临床3期和4期的占70．1％，6岁以上患儿的平均CD4细胞计数为（137±159）／μL，1岁以内患儿为（1246±776）／μL，1～5岁患儿为（304±317）／μL，181例患者伴有不同程度的贫血。患者主要表现为持续发热、皮肤损害、慢性腹泻、鹅口疮及反复上呼吸道感染等。对生长发育影响显示：身高低于-↑x-2s占49．6％，体质量低于-↑x-2s占19．9％。结论现存活的AIDS儿童以6岁以上为主，HIV对儿童感染者的免疫功能、临床进展、生长发育均有显著影响。

Objective To study the clinical characteristic of acquired immune deficiency syndrome （AIDS） patients younger than 15 years old and to explore the influence of human immunodeficiency virus （HIV） infection on them. Methods The clinical information, including demographic profile, clinical stages of the disease, laboratory test results and developmental status were gathered from 275 antiretroviral therapy naive patients. Results Seventy eight point nine percent patients were infected by vertical transmission. Sixteen percent were infected by receiving blood products. The average age was （7.6±3.7） years, with 5 cases younger than 1 year old, 104 cases ranging from 1 - 5 years and 166 cases elder than 6 years. Seventy point one percent patients were classified as stage 3 or 4 according to World Health Organization definitions. The average CD4 count was （ 137 ± 159 ）/μL, （ 304 ± 317 ） /μL and （ 1 246 ± 776 ）/μL respectively in children elder than 6 years, ranging from i to 5 years and younger than 1 year. One hundred and eighty one cases suffered from anemia on different .severity grading. The most common HIV related symdromes included persistent fever, skin damage, persistent diarrhea, oral candidiasis and recurrent upper respiratory tract infection. Among these infected children, 49.6% showed height lower than -↑x - 2s and 19. 9% showed weight lower than -↑x - 2s. Conclusions Most survival pediatric AIDS patients are elder than 6 years. HIV infection can significantly affect the children＇s immune system function,growth and development.